The Wellcome Trust: new funding for mental health science
Authors: Miranda Wolpert, Lynsey Bilsland, Niall Boyce, Kate Martin, Catherine Sebastian
Journal: World Psychiatry (2023)

The Wellcome Trust is one of the world's largest health research funders. The charity has committed to spend £16 billion over the coming decade (2022-2032) on just four priorities. First, to fund curiosity-driven basic research on any topic that advances understanding of life, health and well-being, through thrice-yearly open schemes available to researchers at different career stages. Second, third and fourth, to address three global health challenges that are in urgent need of scientific solution, where Wellcome funding and convening can have maximum impact: infectious diseases, climate and health, and mental health. The fact that mental health is one of these priorities makes Wellcome potentially the largest independent funder of mental health research globally. We seek to use this position to advance our vision of a world where no one is held back by mental health problems. We wish to encourage mental health researchers to apply for all forms of Wellcome funding to help make this vision a reality. They can do this through our regular researcher-driven curiosity-led schemes, where applications can be on any aspect of mental health or neuroscience. Proposals must be led by a researcher in the UK or a low- or middle-income country, but can involve collaborators from all countries across the world. Researchers could also consider applying to specific calls related to infectious diseases or climate and health where relevant, which are generally open to the global community. We also wish researchers to consider applying for our targeted Mental Health Awards, which are designed to advance Wellcome's specific mission to create a step-change in early interventions for anxiety, depression and psychosis. Applications for Mental Health Awards are generally open to researchers in any country globally (with the exception of those not permitted by national policy or UK sanctions) and at any career stage. Over the next few years, we plan to run two Mental Health Awards per year. These will be on key topic areas where Wellcome feels that bold science may lead to breakthroughs in relation to its mission. Awards launched so far (now closed) focused on new ways of addressing cognitive deficits in psychosis; research to illuminate the relationship of sleep and circadian rhythms with anxiety, depression or psychosis; and back-translation projects designed to understand how effectively treatments work for one or more of the target conditions. Details of Mental Health Awards planned up to 2024 are available on our website (https://wellcome.org/what-we-do/mental-health). We are committed to meaningfully involving people with lived experience of mental health problems in our work. Within our mental health team, lived experience experts shape our governance, direction, decision-making and daily work. Our team of lived experience consultants includes people based in the UK, Rwanda, Kenya, South Africa, Indonesia, India and Australia. Unless in exceptional circumstances, we require lived experience to be a key part of everything that we fund. To achieve our mental health mission, we fund with the intention of advancing three goals: a) better understanding of how the brain, body and environment interact in both the development and resolution of the target mental health conditions; b) better ways of identifying and grouping (stratifying) people with, or at risk of, these conditions, so that we can provide more timely and personalized interventions; and c) new and improved ways of intervening at the earliest possible stage in anxiety, depression and/or psychosis. Below we share some examples of projects we have funded so far. These by no means represent a comprehensive review of our portfolio, but are intended to give a flavour of the diversity of projects with potential for achieving our goals. To advance basic understanding, we need to unpick the complex interplay between biological, psychological and social determinants of both the origins and solutions to mental health problems. This includes an interest in the collection and analysis of longitudinal data. We have funded Sage Bionetworks, US to lead a collaboration testing different models of stewardship for mental health data in the UK, South Africa and India. We are funding Prof. L. Kenny from the University of Liverpool, UK to supplement a new cohort to collect microbiome data at birth in the UK, with follow-up to assess impacts on anxiety and depression at later stages. We have also commissioned a global mapping of large-scale longitudinal datasets relevant to our focus worldwide to encourage use by mental health researchers and to consider opportunities for enrichment with additional data or recruitment. The team has identified over 3,000 datasets so far. We are committed to funding research that can help us find more suitable ways of stratifying populations to identify mental health problems, predict their course, and allocate treatment more effectively. We are funding Prof. A. Loch from the Universidade de São Paulo, Brazil to apply language analysis using machine learning to explore if this can predict risk of schizophrenia in a general population. We have launched a major call (open to applications until early Summer 2023) named “Finding the right treatment, for the right people, at the right time for anxiety and depression”. This call aims to support validation of biological, psychological, social or digital markers to enable stratification in anxiety and/or depression as early as possible. Stratification is expected to allow targeted treatment and ensure that the right people get the right treatment at the right time. Wellcome is also committed to funding science that can lead to new and improved pharmacological and non-pharmacological interventions. These could involve actions that individuals do for themselves, or are provided by a health care professional, or are supported by policies or practices in wider society. For example, we are funding Prof. P. Garety of King's College London to examine the effectiveness of a digital simulation (avatar) therapy to reduce the impact of auditory verbal hallucinations1; and we are funding Prof. P. Amminger and his team from the University of Melbourne, Australia to run a randomized controlled trial of cannabidiol among people who are considered to be at high risk of developing psychosis2. To create the change we seek, we wish to help the field of mental health science to cohere and develop. This includes commissioning teams to undertake living reviews and priority-setting to help the wider community identify the most promising areas for future research, and supporting use and uptake of a core set of common metrics for measuring mental health outcomes. We support the convening of diverse groups to advance cross-disciplinary understanding as well as policy change to support our mission, such as around work to clarify the regulation of digital tools in mental health. We also fund work considering the history of theories and debates in mental health science. The field of mental health is complex and often controversial. We have no illusions about the challenge ahead of us in delivering a diverse yet focused programme of activities that will provide the progress and transformation which is so badly needed by people living with mental health problems worldwide. We are prepared to take risks and recognize that not all projects will bring the impact we seek. If none of the projects we fund fail, then we are not being brave enough. We are open to bold ideas from those working in the field, and beyond, that can bring us a step closer to effective early intervention for anxiety, depression and psychosis. We are trialling a suggestions box on our website where anyone can share ideas for how we should target our funding, advocacy or convening to best achieve our mission. We encourage the readers of World Psychiatry to share their thoughts with us. The funding that Wellcome has committed to mental health is both a great responsibility and a unique opportunity to transform the state of this vital aspect of human and societal health. We look forward to working with many of you to achieve our shared vision.